Making a case: Testing service provides 'objective' data

Sunday, March 31, 2002

One of the biggest disadvantages the HME industry has had in its futile campaigns against reimbursement cuts is providing product data that payers accept as reliable. Long skeptical of claims linking product performance with positive patient outcomes, payers have historically dismissed this information as proprietary and self-serving propaganda.

But armed with Valley Inspired Products' testing results, providers may finally have the evidence they need to make a convincing case. By presenting product data collected by a neutral third party, payers can no longer automatically assume that it contains an industry bias. And Valley's officers hope the testing program will give the HME industry more credibility with both the payer and clinician communities.

"Payers typically don't care how a product works, but (ironically) product is what they base their reimbursement on," said Bob McCoy, RRT, Valley's managing director. "Likewise, clinicians see products simply as commodities. As a clinician myself, I had the same opinion. But since we've been doing product testing, I now know that there is a definite correlation between product performance and patient response."

Pete Bliss, Valley's technical director, also recognizes the dilemma providers face with reimbursement cuts and payer indifference.

"There is a disconnect between the person making a buying decision and the person most concerned about the patient's well being ­ the patient," he said. "A disconnect also exists between the cost of products and the people paying for the patient's care. It is quite difficult, if not impossible, to sell a product that is more convenient for the patient if it costs more, even if it can improve the patient's health."

Valley, which focuses on testing respiratory products, has studied numerous devices since 1995. What began with a comparison study of oxygen conservers eventually spawned a company.

Bliss and McCoy formed Valley and launched a three-tiered menu of services: product development, market research and product testing. Oxygen devices reviewed to date include traditional CPAP, auto-adjust CPAP, bi-level and critical care ventilators, humidifiers, cannulas, oxygen concentrators and cylinder filling concentrators.

Bliss and McCoy contend that testing wasn't "a primary goal" of the business, but that market demand kept building.

"It certainly wasn't on purpose, but it has grown on its own," Bliss said. "I think because there is a grass roots need for it."

Valley's testing program fills an information void that existed far too long, says Bob Fary, national director of respiratory services for Lake Forest, California-based Apria.

"They bring significant value," he said. "The work they do saves the provider from doing extensive evaluations on products while reassuring us that they are objective. I put great weight on the results and the outcomes they publish."

The data contained in Valley's reports also serves as an influential marketing tool for providers to use in negotiating with payers, Fary said.

"We can educate the payer about products with comparison data they know is objective," he said. "It convinces them that we provide quality products. Down the road, I think it will help us get more reimbursement."

During the course of Valley's testing program, Bliss and McCoy say they repeatedly have had to decline requests for product endorsements from both providers and manufacturers.

"Providers constantly ask us for a recommendation on what is the best product, which we refuse to do," McCoy said. "Our job is to tell people how these products work and let them make their own decision. We're not going to give anyone a rubber stamp because there is no 'right' product. People have to make up their own minds about that and only they can make the right decision."

Concurrently, manufacturers typically ask Valley to designate one product as superior to another, Bliss said.

"We won't take on a project if the requirement is to say that Product A is good and Product B is bad," he said. "We've been criticized for not taking stronger stands about what product works best ­ usually by the manufacturer whose product looks best in our study. We think the results should speak for themselves." HME